March 2000

VMW is a monthly Virtual Magazine on Telemedicine and High Performance Computing and Networking for readers interested in computer applications in medical environments. It is produced by an editorial team composed of professionals in publishing and an advisory board with professionals in telemedicine, provides the embedding into the everyday practice and research. You can put the editorial team to work as well. Read about our services and find out about the friendly rates.

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Some of the following articles might have skipped your attention in the past months. Virtual Medical Worlds is offering you a second chance to catch up on a few remarkable telemedical applications and conference presentations.

Special issue with an update on results from European R&D projects, 1999 !

Each year hundreds of European R&D projects produce important results. In this special issue, co-published by the magazines Primeur and VMW, we give an update from a number of projects in the HPCN and medical sectors that were supported within the Esprit or Telematics programmes from the European Commission.

Please, check in at the telemedicine project below:

TeleInViVo, the building of an economically viable telemedical workstation for 3D ultrasound

This special issue is published in conjunction with the ITIS-ITAB 99 event in Amsterdam.

When you want your project results published in one of our next special issues, please contact the editors of Primeur magazine or Virtual Medical Worlds magazine.

ITIS99logof Visit the web site of the second International Conference on the Telemedical Information Society.
Combined ITIS'99-ITAB'99 Conference, April 12-13 1999, Amsterdam.

Also featuring all forum discussions!

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Interactive patient-customised simulator offers surgeons real life "plan, train and rehearse" experience
In Europe, the integration of advanced technologies such as 3D visualisation, virtual reality, and computerised simulation for pre-operative planning, performance and training of surgical procedures is rapidly gaining in interest. Funded by the European Commission's IST Programme, a team of eight partners is setting up an Integrated Environment for the Rehearsal and Planning of Surgical Interventions (IERAPSI). The IERAPSI consortium will particularly focus on the planning, simulation, and training of surgical procedures performed on the petrous bone, a common site with a complex anatomy. The system will address frequently applied interventions, such as mastoidectomy, but equally very exacting ones, like cochlear implantation and acoustic neuroma. In a later stage, IERAPSI might also be used for other surgery specialities.

Medicine Meets Virtual Reality 2000 live conference impressions from an expert in the field
From January 27th to 30th 2000, Dr. Nigel W. John, Virtual Reality R&D Manager at the Manchester Visualization Centre, has attended the annual Medicine Meets Virtual Reality (MMVR) Conference. The VMW Magazine wishes to kindly express its thanks to Dr. John for sharing his vivid conference report with our readers.
The theme of this year's Medicine Meets Virtual Reality Conference, was "Envisioning Healing: Interactive Technology and the Patient-Practitioner Dialogue". The usual wide and varied programme of presentations and workshops covered this and all areas of the application of virtual environments to health care. Conference delegates were up on last year, and around one quarter of delegates came from outside of the United States, mostly Europe. The following presents a snapshot of the conference from my own perspective - apologies to the many good quality presentations that I have not mentioned here.

Open protocols make Electronic Health Records easier downloadable from remote sites
During the second half of the nineties, a CRS4 team headed by Dr. Gavin Brelstaff, worked hard on integrating the Electronic Health Record (EHR) into the hospital information system. The W-MED and Medical Object Web (Medow) projects both served as the solid basis for the Desktop Health InfoBus initiative which culminated last year in an EHR system which relies on the latest Next Generation Internet standard technologies. Both hospital and general practitioner are provided with an efficient multimedia Electronic Patient Record system for information sharing, diagnostic and consultation purposes.

Guidant to order Interventional Cardiology Training Simulator from Virtual Presence
Virtual Presence Ltd., a subsidiary of Muse Technologies Inc., has established a contract with Guidant Corporation to provide a sophisticated cardiology training simulator to Guidant's European headquarters, that are located in Belgium. The agreement is valued at approximately US$500.000. Virtual Presence will undertake custom software development work to adapt the company's existing Interventional radiology/cardiology Simulation-based Trainer (IST) system. Guidant Corporation is based in Indianapolis, USA, as a provider of minimally invasive products and services for the treatment of cardiovascular and vascular disease.

Amdahl key-note speaker in Mannheim
For fifteen years, the Mannheim Supercomputer conference is the meeting place for everyone in Germany and Europe, interested in supercomputer topics. This year, the name of the key note speaker, Gene Amdahl, is associated with a law that everybody in the field has come across. Apart from the new TOP500 list, and applications, ranging from weatherforecast to cardiology, clusters will be a focal point of the conference that will be held in Mannheim from June 8-10, 2000.

New Tflop/s SGI SN-1 for Dutch research
The Dutch National Science Foundation (NWO) has decided to install a new Dutch national supercomputer. The new 1024 processor SGI SN-1 with Tflop/s performance, will propel The Netherlands back in the top 10 of most powerful machines in the world. The SN-1 next-generation Origin machine will be operational in November this year at the SARA computer centre in Amsterdam. The new supercomputer will replace a Cray C90 supercomputer currently in use by Dutch academic researchers for scientific, technical and medical applications. The total value of the contract is approximately 14 million euro.

Swiss research team builds virtual 3D model to simulate cardiac arrhythmia patterns
A multi-disciplinary team of six Swiss researchers with academic and industrial backgrounds has developed a computerised 3D anatomical model of the human atria. This virtual electro-physiology device enables the scientists to simulate several phenomena observed in the human heart, such as normal rhythm, atrial flutter, and atrial fibrillation. The careful study of these complex spatio-temporal mechanisms might eventually lead to a better understanding of the particular elements and causes lying at the source of cardiac arrhythmia.

Success of electronic patient record depends on clinicians' readiness for organisational change
The implementation of an Electronic Patient Record (EPR) system in a health care institution inevitably brings about a series of indirect effects which impose important changes upon the daily workflow and organisation. To make the clinical staff aware of the unsuspected potential provided by the new technology, Ph.D. student Rolf Nikula, who works at the Department of Development and Planning in the Virtual Center for Health Informatics at the University of Aalborg, has designed a model to assess and categorise the ability of individuals and groups to actively contribute to the success of the EPR implementation process. Human factors, such as an organisational and technological insight, are playing a vital role in the acceptance of information technology as a cost-effective tool for quality patient care.

Distant health and social workers discover sense of community identity in computer-mediated communication
Five universities and one international school of public health in Scotland, Germany, Finland and Sweden are partners since early 1998 in a 30-month-project which aims to design multimedia telematics in a client-server architecture, and to assess their use in training modules for health, education and welfare workers in remote areas. SCHEMA which stands for Social Cohesion through Higher Education in Marginal Areas is funded by the European Commission under the Joint Call orchestrated by the Educational Multimedia Taskforce (EMTF). The team will also investigate the role of computer-mediated communication (CMC) and simulation tools to enhance group interaction and encourage the sense of community identity.

DFN-Project Gigabit Testbed West experiences discussed at ZAM in Juelich
In a two day colloquium in Juelich, ZAM (Central Institute for Applied Mathematics) at the Research Center Juelich and GMD (National Research Center for Information Technology) partners of the DFN (German Research Network) Gigabit Testbed West Project presented results of their activities - the Gigabit technology and the applications that used the Testbed. It connected in the first phase ZAM (two T3E 512 and a T90) with GMD (IBM SP2, HPC graphics SGI Onyx 2 and SUN E5000) in Sankt Augustin, near Bonn. DFN disclosed their activities for the Gigabit research network that will be installed in Germany this year, starting in April. Applications presented included multimedia applications, multiscale molecule dynamics, visualisation at the responsive workbench e.g. in medicine, distributed computation of climate and weather models, distributed, virtual production of television, distributed traffic simulations and visualisation, magneto-encephalography and pollution propagation. DFN will install a G-WiN (Gigabit Resarch net) in April 2000. The transition to the G-WiN will be supported by the German Ministry of Research (BMBF) with about 80 Million DM (40 Mio euro). In the first step 622 Mbit/s will be realised and extended to 2.4 Gbit/s for level 1 POPS. The access capacity for the customer in a center will be extended from 622 Mbit/s to 2.5 Gbit/s in 2001 and to 10 Gbit/s in 2003.

IBM participates in SNP Consortium to construct map of genetic diversity
IBM is joining the SNP Consortium in its collaborative effort to create a public database of gene markers that will enhance understanding of the biological basis for disease. IBM will assist ten leading pharmaceutical companies, the Wellcome Trust, and Motorola Inc., in this two-year, $50 million initiative to identify and analyse genetic markers, known as single nucleotide polymorphisms or SNPs, pronounced as "snips".

Researchers provided access to SAGE cancer-related genetic database via
Genzyme Molecular Oncology and Compugen Ltd. have entered into a collaboration that will expand global access to Genzyme's proprietary SAGE database. The collaboration will increase revenue opportunities for both companies while enabling customers to increase research productivity and more rapidly clarify the role of genes in disease. Genzyme Molecular Oncology's patented SAGE technology enables users to identify genes as diagnostic markers and therapeutic targets for potential drug development.

Just how overheated can the U.S. e-health and telemedicine business get?
As health care Internet stocks continue to demonstrate heated activity, everyone is asking how "" companies can be so grossly overvalued, especially when nothing is being sold. The Feedback Research Services team has investigated to which extent the recent e-health, home care and telemedicine market projections within the United States can actually be substantiated.

Stanford selects TouchSense Technology for anatomy and surgery training over Next Generation Internet
Immersion Corporation, the technology innovator and leader of sense of touch interaction technology, will team with the Stanford University Medical Media and Information Technologies (SUMMIT) group to enable the design of advanced, educational medical applications using Immersion's TouchSense technology. Under a research contract from the National Library of Medicine, part of the National Institutes of Health (NIH), SUMMIT will work with Immersion and several collaborators at renowned universities to develop touch simulation technology for training over the Next Generation Internet (NGI).

Digital Anatomist information system based on intelligent conceptual framework
For almost ten years the University of Washington (UW) Structural Informatics Group is working on the Digital Anatomist project. The aim is to build an intelligent Web-based anatomy information system, accessible from any desktop computer for both students and clinicians. To this purpose, the research team has designed a conceptual framework to classify all structural information. This allows the user to query the knowledge base for particular anatomic problems and retrieve dynamically generated 3D images, related to the specified issue. The Digital Anatomist comprises a continuously growing set of modules, that consists of visual databases, 3D modelling and real time rendering software, as well as virtual reality tools.

Martin, the Virtual Nose Simulator, paves way for safer sinus surgery performances
The N in ENT which stands for the ear, nose, and throat medical practice, may never become the same again when otolaryngologists start to incorporate Lockheed Martin's endoscopic sinus surgery simulator into their training regimens. The Akron business in Ohio has partnered with MedOps LLC to market the new tabletop device, selling its first commercial simulator to Montefiore Medical Center in the Bronx, New York, for use by its residents who started the initial testing in January. Each year, there are over 400.000 sinus surgeries performed in the United States, and more than fifteen million Americans are afflicted with chronic sinus ailments that this type of surgery could possibly remedy.

Maine Medical Center to deploy PACS and Point-of-Care applications through advanced Gigabit Ethernet technologies
Maine Medical Center (MMC), the largest hospital in northern New England, has launched advanced Gigabit Ethernet e-Networks in four major sites to increase the effectiveness of its health care services. The $2 million 2500-user e-Networks are based respectively at the hospital's main Bramhall campus in downtown Portland, an oncology centre in nearby Scarborough, an information technology facility equally in Portland, and an ambulatory surgery and surgical care centre at their Brighton facility two miles away from the Bramhall campus. Each site is using a Gigabit Ethernet local area network (LAN) based on 3Com Corporation's next-generation CoreBuilder 9000 enterprise switch.

VitalCom's real time SiteLink telemedicine system turns Sutter Memorial into e-hospital
VitalCom Inc. has successfully implemented its largest real time SiteLink cardiac telemedicine system at Sutter Memorial Hospital. The company's SiteLink product enables Sutter Memorial Hospital, a 346-bed regional tertiary care facility to provide 24-hour monitoring for up to 40 patients at the 357-bed Sutter General Hospital, located three miles away.

Mayo Clinic to try out new laparoscopic procedure for kidney removal
An innovative surgery method has been performed at Mayo Clinic Hospital in Arizona to cut away a patient's diseased kidneys by means of laparoscopy. The pioneering technique just requires a small incision which allows the patient to recover much faster and leave the hospital sooner than before. Mayo Clinic Hospital constitutes the only medical centre in the region to offer this kind of procedure.

Guidant to start with initial clinical trials on its Radiation Coronary Stent System
Guidant Corporation, a global leader in the treatment of coronary artery disease, has begun initial clinical trials on its radiated coronary stent as a potential treatment for heart disease. The trial began with the first human implant of the company's ACS MULTI-LINK Radiation Coronary Stent System. This successful implant was performed by Dr. Patrick Serruys at the Thoraxcentre in Rotterdam, The Netherlands. That particular procedure was the first of approximately thirty that will be conducted to assess the safety of the company's radiated stent, prior to the initiation of broader clinical trials.

Healtheon/WebMD to select partners for medical e-commerce and disease-focused health care information dissemination
Things are moving at an astonishingly rapid pace in the e-health portal business. Healtheon/WebMD Corporation, which is the first end-to-end Internet health care company connecting physicians and consumers to the entire health care industry, and Inc., a leading e-commerce solution for health care supply procurement, have entered into an agreement to design and operate a new and integrated e-commerce marketplace for the procurement of medical and non-medical supplies by physicians. In turn, Medtronic Inc., a medical technology company, intends to form an exclusive four-year $100 million global partnership with Healtheon/WebMD to provide health care information on the Internet and other communications media to consumers and physicians.

U.S. Navy and Department of Defense trust Kaneb's telemedicine group with PACS implementation
Kaneb Services Inc. has just made public that its wholly owned subsidiary, InformaTech Inc. (ITI), one of the major medical and information technology services providers, recently received a new telemedicine contract and extended another existing project for an indefinite period.

Capsule Technologie to receive venture capital destined for innovative health care technology development
Capsule Technologie has been selected as the first company to receive investment capital from Air Liquide's venture capital fund. Launched last November, Air Liquide Ventures chose Capsule Technologie for its use of novel information technologies to provide innovative services to health care professionals. Capsule Technologie has developed a revolutionary solution for integrating patient data into health care management software.

No legal disability for L&H's continuing expansion into medical transcription market
Lernout & Hauspie Speech Products made public that the United States District Court for the District of New Jersey has denied a motion filed by MedQuist against L&H and certain of its officers seeking to enjoin L&H's entry into the medical transcription market. The motion was part of an action, filed on January 14, 2000, seeking a preliminary injunction to prohibit L&H from improper use and dissemination of MedQuist's confidential information and to enjoin L&H from entering the medical transcription market.

Vital Images to receive patent for automated protocol selection in Vitrea 2 software
Vital Images Inc. has just been issued the United States Patent No. 5,986,662 entitled "Advanced Diagnostic Viewer Employing Automated Protocol Selection for Volume-Rendered Imaging" from the U.S. Patent and Trademark Office. The patent covers the mechanism for automated protocol selection, which is utilised in the company's Vitrea 2 software for Windows NT.

New HTML standard XHTML approved
The World Wide Web Consortium has approved a new standard XHTML. XHTML is the well-known HTML 4.0 used on the Internet today, but then reformulated in XML. XHTML documents have to conform to somewhat stricter rules than HTML documents. The advantage is that XHTML can be used in a wide range of applications, ranging from small mobile devices that use a mini browser, for instance for telemedical applications over long distance, to exchanging information between large scientific datasets that are to be processed by supercomputers.

HealthScribe receives $9 million investment from Grotech
HealthScribe Inc., a Sterling, Virginia based national medical transcription company, has received a lead investment of $9 million from Grotech Capital Group of Timonium, Maryland. HealthScribe will use the capital to expand its technical and production capacity and continue as the fastest growing Internet-enabled provider of medical transcription.

Innovative Web-based analytic tool able to link drugs to diagnosis
National Data Corporation (NDC) Health Information Services and PharMetrics Inc. have established an agreement to co-develop and co-market a web-based business-to-business analytical tool measuring pharmaceutical brand performance by linking diagnosis to prescription use.

Dinosaur computers able to diagnose cancer in thirty seconds
During the First International Three-Dimensional Endoscopy Conference held in Parma, Italy, Dr. Roberto Passariello, who is a radiologist and professor at the University of La Sapienzia in Rome, stated in his lecture that diseases such as colon cancer could be diagnosed in thirty seconds with the use of a computer similar to those applied to create the dinosaurs in the film "Jurassic Park".

Supercomputer to bring some light in misty past of AIDS virus
The worldwide AIDS pandemic has been traced to a single viral ancestor who emerged perhaps around 1930. Earlier research had suggested that the outbreak began in the first half of the 20th century, but the latest analysis, performed at the Los Alamos National Laboratory in New Mexico, appears to be the most definitive so far.